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The primary aim of this study is to investigate whether multisensory integration (MSI) mechanisms observed in patients with right hemisphere lesions without neglect remain intact compared to patients with Unilateral Spatial Neglect (USN).
This study also allows for a direct comparison between results from paper-based tests and computerized tests, as well as between patients with right hemisphere lesions without neglect and USN patients. The secondary objectives are:
To compare these results in order to obtain a more refined definition of USN at both the unisensory level (as computerized tests are rarely used in hospital settings but have proven effective in diagnosing USN) and the multisensory level (since USN is not generally tested in the auditory modality).
To measure eye movements in all patients in the study, as this can provide useful information for characterizing patient deficits.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with right hemisphere stroke (Without USN) |
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| Patients with right hemisphere stroke (With USN) |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Classical and computerized assessment | Diagnostic Test | Patients with right hemisphere stroke will undergo a battery of standardized paper-based tests, as part of routine clinical practice, including cognitive assessments. Additionally, they will complete computerized tests involving the presentation of unisensory (Auditory or Visual Stimuli) and multisensory stimuli (visual and auditory stimuli) |
| Measure | Description | Time Frame |
|---|---|---|
| Multisensory Computerized Test | The test is structured into three tasks that characterize the patient's deficits through visual and auditory stimuli. In Task 1, 100 light items are presented in two blocks of 50, while in Task 2, the patient interacts with 36 sound items in a single block. During these tasks, the patient, seated in front of the computer, must localize the sources of light and sound. The lights are generated on the screen using software like MATLAB, while sounds come from speakers mounted on the screen. The patient's responses are recorded via a microphone and noted by the experimenter using the keyboard. | The assessment is conducted within a week of admission to the ward. |
| Multisensory Computerized Test | In Task 3, the presentation occurs simultaneously, with 360 items distributed across 12 blocks of 30 items each, repeated over three days. In this case as well, the patient must localize the sources of light and sound. This integrated approach allows for a thorough evaluation of sensory localization abilities and analyzes the interaction between visual and auditory stimuli in the patient. | Is conducted over a total of three different days, during which the patient will complete Task 3 in three separate sessions, one for each day. |
| Measure | Description | Time Frame |
|---|---|---|
| Mini Mental State Examination (MMSE) | (Range: 0-30; higher score=best performance). | The assessment is conducted within a week of admission to the ward. |
| Apple Cancellation Test | The Apple Cancellation Test is a neuropsychological assessment that evaluates visual attention and neglect, both egocentric and allocentric, particularly in patients with brain injuries. During the test, participants are presented with a sheet containing a grid with 15 apples per cell: three large (one without an opening, one with an opening on the left, and one with an opening on the right) and 12 small apples (four without openings, four with openings on the left, and four with openings on the right). Participants must cancel the target apples within a set time frame. The total score is based on the number of targets canceled, with a maximum of 50 apples. Additionally, an asymmetry score for egocentric neglect is calculated, representing the difference between the number of targets selected on the right side (boxes 1-4) and the number of targets selected on the left side (boxes 7-10). Higher scores indicate better performance, while lower scores may suggest difficulties in attentio |
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Inclusion Criteria:
As a control group, patients will also be included if they have:
Exclusion Criteria:
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Patients with stroke who have right hemisphere lesions and showed USN.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Azienda Ospedaliera Universitaria Integrata Verona - UOC di Neuroriabilitazione | Verona | verona | Italy |
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| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D020521 | Stroke |
| ID | Term |
|---|---|
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
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| The assessment is conducted within a week of admission to the ward. |
| Line Bisection Test | In the Line Bisection Test, the patient is asked to mark the midpoint on a series of lines. For each line, a score is assigned that ranges from 0 to 3: a score of 0 indicates an inaccurate indication, while higher scores (up to 3) indicate greater accuracy. The scores are summed to obtain an overall total that ranges from 0 to 9. Higher scores indicate the absence of asymmetry and greater precision in performance. | The assessment is conducted within a week of admission to the ward. |
| Catherine Bergego Scale (CBS) | The Catherine Bergego Scale (CBS) is a clinical tool for measuring unilateral spatial neglect in patients with brain injuries, assessing how it impacts daily activities. The scale includes 10 activities (e.g., body orientation, mobility, personal care), each rated on a score from 0 to 3, where 0 indicates no neglect and 3 indicates severe neglect. The total score ranges from 0 to 30: higher scores indicate greater severity of neglect. | The assessment is conducted within a week of admission to the ward. |
| Visual neglect test | Visual Field Testing: Assessing the ability to perceive visual stimuli in different quadrants can help identify neglect. Patients may be asked to report stimuli presented in specific visual fields, with significant omissions indicating neglect. | The assessment is conducted within a week of admission to the ward. |
| Mini Mental State Examination (MMSE) | (Range: 0-30; higher score=best performance). | During the assessment required for the neuropsychological evaluation of the patient, conducted as per standard clinical practice upon admission to the ward. |
| Tactile neglect test | Tactile Extinction Test: Patients are touched on both sides of the body simultaneously and must report where they feel the touch. If they can only report touch on one side when both sides are stimulated, it indicates tactile extinction and suggests neglect. | The assessment is conducted within a week of admission to the ward. |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |